Colonic Polyp Study: Differences in Adenoma Characteristics Based on Colonoscopy History over 5-Year Follow-Up Period

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Colorectal cancer (CRC) prevention relies on timely detection and removal of colonic adenomas.
• Understanding adenoma characteristics based on patient history is crucial for optimizing screening protocols.

Purpose of the Study:

• To investigate how colonoscopy history impacts the location and features of colonic adenomas and advanced neoplasia.
• To determine if tailored surveillance strategies based on prior colonoscopy can enhance adenoma detection rates.

Main Methods:

• Retrospective analysis of medical records from 14,029 patients undergoing colonoscopy in Korea (January-June 2020).
• Categorization of patients into first-time, <5-year, and ≥5-year colonoscopy history groups.
• Comparison of adenoma and advanced neoplasia characteristics (location, morphology) across different history groups.

Main Results:

• Adenoma and advanced neoplasia prevalence and features significantly differed based on colonoscopy history (p < 0.05).
• First-time screening showed higher adenoma rates in the sigmoid colon and rectum (Is, non-granular LST).
• Repeat screening (<5 years) revealed adenomas in the transverse and descending colon (IIa, IIb features), while ≥5 years showed them in the ascending colon and cecum (Ip features).
• Advanced neoplasia distribution also varied, with specific locations and features correlating with screening history.

Conclusions:

• Colonoscopy history is a significant factor influencing the location and morphology of colonic adenomas and advanced neoplasia.
• Targeted examination of specific colonic segments based on prior screening history may enhance adenoma detection.
• Further large-scale prospective studies are warranted to validate these findings for clinical application in CRC prevention.